The main weakness of the classical external þxator is the penetration of the bone, this conducting to the entrance of the pathogenic germs by their migration toward the pins.

Despite the fact that the centromedullary synthesis is done after several weeks after the removal of the external þxator the risk of infection after the operation remains signiþcantly high. Considering these theoretical assumptions and experiencing in our current practice such complications we have started to use 3 years ago the pinless external þxator for the stabilization of the tibia fractures.

Between 1999–2002 there were hospitalized and operated 213 patients with open tibia fractures, 28 being treated using the pinless external þxator.

From those cases PEF was used for 9 patients with type II lesions, 8 patients with type IIIA lesions and 3 patients with type IIIB lesions.

After resolving the soft tissue injuries (approx. 2 weeks) the external stabilization was converted to internal centromedullar solid stabilization, without the risks associated with the use of the classical external þxator.

Our conclusion was that the external pinless þxator is less invasive, stable and realize a good adherence to the bone. This guarantees the centromedullary conversion of the osteosynthesis with minimal risks, as it doesnñt expose the medullar cavity of the shaft.